Tales from the Emergency Department; in which a man who wallows in nostalgia, and secretly wishes he were a Victorian KnifeMan rants about his work and what passes for a life.
He's heard it might be therapeutic...
Names have been changed to protect the innocent.
Any resemblence to parties alive or dead is purely coincidental

Tuesday, March 27, 2007

I seem to have an increasingly hard time 'putting pen to paper' of late.

I still feel a bit pressured at work; I'm guessing that's not helping. Also it seems like an increasing number of people I know keep finding this blog. I know this is ridiculous, because I haven't really made any attempt to anonymise myself, so should have expected it really; but I didn't. I guess I thought too little traffic wandered over to my little corner. Ah well.

So where are we at?

MMC / MTAS continues to fall apart around our ears, taking with it the careers of so many doctors. Just thinking about it makes me alternately furious and depressed. And I've got a job.

My yearly assessment draws near. And my paperwork isn't up to date. Ask not for whom the Bell tolls; it tolls for Shroom

Emotionally, work has been fairly shit the past week or so. I've treated several patients whose diagnosis appeared deadly obvious to me, but who seemed oblivious to the possibility themselves. It's like being the worst kind of fortune teller in the universe. I'm sure all the medics out there know the world know the feeling...

Patients present with what seems, to them, to be an innocuous collection of symptoms. To me, coupled with the inevitable signs they haven't noticed, or are denying, it's anything but innocuous. The knowledge that around the corner awaits the instruction to "get your affairs in order" fills me with nausea. I realise I'm being selfish, because at least I don't have to hear that about myself. But for a few moments when I'm certain of my dreadful diagnosis, I feel shit because I have to bear it alone. No-one can share my burden.

Then you divest yourself of your dark suspicion, your foetid information all but stinks up the room; a miasma of misery. Now it's their burden, not mine, and I don't have to shoulder the weight anymore.

I don't feel any better. Just a little more selfish, for trying to ease my pain with theirs.

Some days it seems all you do is ruin people's days, and, by extension, their lives.

Tuesday, March 13, 2007

More on this in a bit; I'm not really in the mood for navel gazing. I'm in the mood to vent. I often get to work early. It gives me a chance to have a coffee, catch up on e-mails and generally ease myself into the day.It also makes one a target for people who say things like "As you're here, would you just..."

Of course, the argument runs, if you don't want to be asked questions, hide. (Or don't go in early..?) Either way, I accept this is going to happen, especially in this business. But I reserve the right to say that I'm not on duty. If the fuckers are going to treat me like shit, they can't expect 110% from me. Which I know isn't very caring, but there you go. We're not talking about life and death shit here.

So, there seem to be two ways a person might approach the early Shroom at work, while he is quite clearly attending to personal business, and not at work.

--- Firstly, you might bid the Shroom good morning and ask if he wouldn't mind reviewing a patient, as the SHO is tied up, and it'll save delays, etc.

Unless I'm in a really bad mood, I'll do it.

--- Secondly, you might march up to the Shroom. Do not say hello, do not introduce yourself. Instead, start moaning about the grief management is handing out about The Situation. Demand to know what Shroom is going to do about it. Look aghast when he explains he's just walked in, and doesn't know anything about The Situation. For extra sympathy, walk off while he's talking to you.

Whatever mood I was in before you started, it's now bad.

Of course this sort of thing could never happen in the NHS. Managers there value their Doctors, and more importantly, their patients as humans, not numbers, or targets. And God forbid that such a situation arose because the Management couldn't get the Department staffed adequately overnight.

In case you were wondering, the situation here might have been, for example, that waiting times had reached three hours. They hadn't, of course, so I'm sure that wasn't it.

Friday, March 09, 2007

I've been in absentia for a while; sorry. For my occasional reader - no, I have not thrown you over. How could you think such a thing?! I've just been lazy preoccupied. But I'm afraid I'm still not letting anonymous posts in.

I can't really explain why I've gone off the boil of late. I suspect mostly because I ran out of things to say. This will become increasingly apparent as you read on...

I've been a little busy, too. Two of my very good friends got married at the end of February. A grand time was had by all, and sometimes it seems the only time we can manage a get together these days is Weddings or funerals. Which is a shame, really.

Work is beginning to get me down, again. Ironically, I can consider myself lucky, because at least I don't have to contend with the MMC/MTAS shit. But, my sloth, as always, is catching up with me, as the amount of extra-curricular work I should have produced grows ever further from the actual amount. I fucking hate research. I'm not interested in it, and I'm no good at it. Why can't it be left to those who are? I do enjoy teaching, and seem to be passably good at that. Why can't I trade?

Whatever; a period of hard work beckons. I need to focus.

I am pleased to see the medical profession develop some backbone over MTAS. As readers of my previous posts will know, I am fed up to the back teeth of the disregard, the disrespect that successive Governments have shown the medical profession. I have to curb my enthusiasm most of the time, for fear of sounding like the arrogant fucker I so nearly am.

But enough is enough. Unfortunately, my fear is now that the profession will descend into chaos, as no-one gets a job, or knows what the fuck is happening. I predict an orgy of finger pointing, as people struggle to distance themselves from this god-awful disaster.

The Royal Colleges have started; this comes as no surprise, as they are supposed to be the guardians of post-grad training, and collect ample cash from trainees. It's too little too late, as far as I can see. It is risible and contemptuous of them to now try and blame the government. The Royal Colleges were not in the dark about the monumental shafting being planned; but they sat back doing nothing.

How have we become so impotent in controlling our own destiny?

And yet we soldier on.

At work, a very young child was brought to us in extremis. I wasn't present, but such a terrible event leaves a miasma of grief behind it. The whole department is tensed, looking for ways to void the grief. But it will not be drawn tonight. We have been to busy, rushing from crisis to crisis, and the day staff, who bore the brunt of the psychological onslaught are at home now. I hope none of them are alone.

At the same time, a patient with some non specific limb pain took it upon themselves to start throwing shit at the nursing staff. This patient was not demented, not delirious. She was in full possession of her faculties. It was a deliberate, spiteful act. And it goes unpunished. This sort of thing really brings my contempt for this whole system to the fore. I cannot think of another profession where this would be acceptable.

I might try going to my bank tomorrow, and if I have to queue for more than a minute, start throwing faeces at the teller.

Lastly, I was struck tonight by another vignette you only see in hospitals. Parents with sick children bring in their favourite toys, to try and smooth the experience. Fair enough, but it looks a little incongruous to meet a flustered parent, red faced and anxious, furiously gripping a massive plastic elephant in one hand, and some unidentifiable soft toy in the other.

Legal Disclaimer

All the patient details reperesented here are composite. The details of my movements and activities are as accurate as I can make them, but the rest is largely made up. The Shroom's opinions do not represent those of the NHS at large, and should not be taken as a substitute for seeing a proper doctor. Lastly, and for what its worth, all the material herein is copyright The Shroom, and I reserve the right to send large bald men to your place of residence if you reproduce it without permission.